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Dr Halliday’s PhD is on Remodelling, risk stratification and personalising therapy in dilated cardiomyopathy. We had a chat with him to discuss his research.

You trained as a doctor and currently working on your PhD. What attracted you to a career in medicine?

I am from a medical family. My father is a retired doctor, my mother is a retired nurse and my sisters are both doctors. I was never directly encouraged to go into medicine but growing up in that environment you become accustomed to that way of life. With your parents as your role models, it follows suit that you develop similar interests.

At about fourteen or fifteen I decided that’s what I wanted to do and I haven’t looked back since. I have always enjoyed problem solving and I enjoy the challenges we face in medicine; trying to work out what’s wrong with patients and then the best way of trying to manage them.

Dr Brian Halliday research fellow

Please tell me about your PhD

My PhD is looking at patients with dilated cardiomyopathy. This results in a person developing a ‘baggy and weak’ heart due to problems with the heart muscle rather than the more common problems with high blood pressure or coronary artery disease. Part of the project is looking at patients whose hearts recover function with medications and whether they need to continue to take medications in the long term.

We are interested in whether there are patients we can identify who don’t need to take medication and can safely come off them – we are looking at this in more detail in a small clinical trial. The other part of the project involves trying to predict those patients at the other end of the spectrum who don’t do as well and are at highest risk of heart rhythm problems and sudden death.

Both projects are aimed at allowing us to treat patients more precisely and more personally by using modern techniques to characterise their condition in greater detail. By characterising them in greater detail we will hopefully be able to predict more accurately what happens to them in the future, what treatment they need and importantly also what treatments they will not benefit from.

How might your research benefit patients in the future?

I think with the first aspect of my PhD - looking at whether patients need to stay on medications or not, we can begin to provide some information on which patients may be able to stop their medication. As we’ve conducted the research we’ve realised that the question of whether patients need to stay on medication or not is a very important question for patients. They are showing lots of enthusiasm in taking part in the research.

We do hope in the future that we will be able to give them better answers to the question on who needs to stay on medication and who doesn’t . For patients of all generations, who are completely symptom free and don’t want to be taking medications for the rest of their life, it’s obviously a very important question.

The other aspect of my research is trying to identify those at greatest risk of problems with dangerous heart rhythms that can result in sudden death. For those at greatest risk of these problems, we often recommend an implantable defibrillator. Recent research shows that we need to find better ways of identifying patients at greatest risk. We are investigating whether MRI scans of the heart allow us to do this.

What has been your experience of patient and public involvement in research so far?

Over the past year we have had lots of involvement with patients and the public through the public involvement team here, including discussing my project with the cardiovascular BRU patient advisory group and running a table talk at the Trust’s annual research open day. We have also had tremendous help from Cardiomyopathy UK and Pumping Marvellous who have promoted the study to their members.

Over the past year we have had lots of involvement with patients and the public through the public involvement team here, including discussing my project with the cardiovascular BRU patient advisory group and running a table talk at the Trust’s annual research open day. We have also had tremendous help from Cardiomyopathy UK and Pumping Marvellous who have promoted the study to their members.

It has been really valuable in helping us shape the direction of the research and trying to make the research acceptable for patients, answer questions that they want to be answered and making the study design most convenient for them. It’s really important to get their enthusiasm because they are the ones we are asking to give up their time – we have to make participating as pleasant as possible for them. It has been a really positive experience with lots of very enthusiastic and well informed patients and I think collaboration with them in really valuable.

And finally, how do you think your PhD will help your career in medicine and do you think this will include research?

During a PhD you learn completely different skills to the skills you acquire in clinical medicine. Although we are part of a big team here, the responsibility for your research lies with you and there is no one to ‘hand-over’ at the end of the day. I think over the course of a PhD, people probably develop a little bit more independence. I have learnt a tremendous amount about the design and methodology of clinical research and in particular clinical trials. There are a lot of aspects to consider and certainly, the experience with the current study will hopefully make future studies a little bit easier! As part of my research I am also being trained in cardiac MRI and this is something I want to develop and pursue in my future career. The projects are very clinically focused, so I am also learning a great deal about the cutting edge of practice and research in heart failure and cardiomyopathy.

At the moment I do see myself doing research in the future. I would like to combine academic and clinical practice in heart failure and cardiac MRI and keep an active role in research in the future.